HOCS v3.0 Methodology
How Inkwell scores healthcare companies
The Inkwell-Rated HOCS score evaluates a company's readiness to partner with health systems across four dimensions and 20 sub-criteria. Every score is based on verifiable evidence using a published rubric. No pay-to-play, no anonymous opinions, no hidden methodology.
What we measure
HOCS stands for Health System Readiness, Operational Maturity, Clinical Evidence (or Credibility & Evidence, for non-clinical companies), and Scalability & Fit. Each dimension is scored 0–100 from the underlying sub-criteria.
Health System Readiness
Whether the company is structurally ready to partner with a health system today. Covers integration depth, security posture, the existing book of named health system relationships, the implementation methodology, and whether health systems are a primary market rather than an opportunistic one.
Operational Maturity
Whether the company can sustain a multi-year health system partnership. Covers leadership healthcare experience, customer stability and expansion patterns, financial backing relative to stage, customer success infrastructure, and transparency in pricing and reporting.
Clinical Evidence
Whether the company can substantiate its claims with credible evidence. The C pillar splits into two tracks: clinical companies are scored on published research, regulatory standing, and outcomes evidence; non-clinical companies are scored on ROI substantiation, independent industry recognition, methodology documentation, subject-matter authority, and cross-system outcomes.
Scalability & Fit
Whether the company can deploy at scale and adapt to diverse health systems. Covers enterprise deployment depth, reference availability at senior levels, strategic and operational fit, pilot program accessibility, and product configurability across specialties and populations.
The 20 sub-criteria
Each dimension is built from 5 sub-criteria. Each sub-criterion is scored 0–20 against a tier ladder of explicit definitions. The full tier ladders are visible directly within each company's detailed score breakdown.
Health System Readiness
- h1
EHR Integration
Depth of integration with major EHR systems.
- h2
Security, Compliance & AI Governance
Security certifications, compliance posture, and AI governance practices.
- h3
Health System Engagement
Number and diversity of active health system client relationships.
- h4
Implementation & Clinician Experience
Documented implementation methodology and clinician co-design practices.
- h5
Health System Focus
How purpose-built the company is for the health system market.
Operational Maturity
- o1
Healthcare Operating Experience
Leadership team experience operating inside health systems.
- o2
Customer Stability
Customer durability, scope expansion within existing customers, and absence of public terminations.
- o3
Funding Stability
Financial backing appropriate to stage and visible runway for multi-year commitments.
- o4
Customer Success
Dedicated customer success infrastructure, SLAs, and proactive support.
- o5
Transparency & Reporting
Public pricing, outcome reporting, model card transparency where AI applies.
Clinical Evidence
- c1
Track-dependent: Published Evidence (clinical) or ROI Substantiation (credibility).
- c2
Track-dependent: Regulatory & Institutional Validation (clinical) or Independent Industry Recognition (credibility).
- c3
Track-dependent: Study Rigor (clinical) or Methodology Documentation (credibility).
- c4
Track-dependent: Clinical Advisory (clinical) or Subject-Matter Authority (credibility).
- c5
Track-dependent: Documented Outcomes Evidence (clinical) or Cross-System Outcomes Evidence (credibility).
Scalability & Fit
- s1
Deployment Depth
Enterprise-scale deployments measured by user volume and system breadth.
- s2
Reference Availability
Availability of senior-level customer references willing to speak with prospects.
- s3
Strategic & Operational Fit
Strategic alignment with current C-suite buying priorities and operational fit across health system types.
- s4
Pilot Pathway
Structured pilot programs with defined scope, duration, success metrics, and pricing.
- s5
Adaptability & Customization
Product configurability across specialties, populations, and care settings.
How tiers work
Every sub-criterion is scored on a 5-tier scale. Tier definitions are criterion-specific, written to describe what evidence corresponds to each tier rather than generic adjectives. The thresholds for moving up a tier are visible inside each company's detailed breakdown.
No evidence
No documentation or signal that the criterion is addressed.
Minimal or early-stage
Stated intent, roadmap, or initial activity without demonstrated capability.
Moderate
Demonstrated capability with traction, but with visible gaps relative to peers.
Strong
Clear capability across multiple instances or contexts, with documented evidence.
Industry-leading
Recognized as among the strongest in the category, with breadth and depth of evidence.
N/A normalization. When a sub-criterion genuinely does not apply to a company's business model (for example, EHR integration for a workforce training company), it is marked N/A and excluded from the dimension calculation. This prevents penalizing companies for criteria irrelevant to their value proposition.
How scores map to bands
The overall HOCS score is the average across the four dimensions, rounded to a whole number. Scores roll up into four public bands that reflect partnership readiness rather than absolute quality.
85–100
Top decile. Deep evidence across multiple dimensions, suitable for enterprise-scale partnerships.
70–84
Demonstrated capability with health system traction. Suitable for active evaluation and pilot conversations.
55–69
Emerging readiness. Foundational evidence in place, with visible gaps relative to top-tier peers. Worth tracking and engaging early.
0–54
Limited public evidence relative to the rubric. Detail visibility is gated to the company itself; bands remain public.
Why a band, not just a number? A single 0–100 score can imply false precision. Bands acknowledge that the distance between an 82 and an 84 is much smaller than the distance between a 64 and a 76. Health system leaders evaluating vendors care about whether a company is operationally ready, not about a single-digit ranking.
Clinical and Credibility tracks
The C pillar uses two parallel evidence frameworks. A diagnostic device, therapeutic, or clinical care delivery company is evaluated on published research, regulatory standing, and clinical outcomes. A workforce platform, analytics product, supply chain solution, or revenue cycle product is evaluated on ROI substantiation, industry recognition, methodology documentation, and cross-system outcomes evidence.
Clinical track
Clinical Evidence
Companies with FDA-regulated products, direct patient interventions, clinical devices, therapeutics, diagnostic tools, or clinical care delivery models. Sub-criteria cover Published Evidence, Regulatory & Institutional Validation, Study Rigor, Clinical Advisory, and Documented Outcomes Evidence.
Credibility track
Credibility & Evidence
Everything else: IT platforms, workforce, analytics, advisory, SDoH, supply chain, revenue cycle, patient access, interoperability. Sub-criteria cover ROI Substantiation, Independent Industry Recognition, Methodology Documentation, Subject-Matter Authority, and Cross-System Outcomes Evidence.
Evidence submission
Scored companies can submit evidence to challenge or strengthen a specific sub-criterion score at any time. Submissions are reviewed within seven business days and resolved as Approved (new score applied), No Change (current score stands), or Declined (request did not meet review criteria).
Onboarding window
In the first 30 days after a company is scored, evidence submissions are encouraged. Cooling-off rules do not apply during this period.
One open request per criterion
A company may have at most one open request per sub-criterion at any time. This keeps the review process focused and prevents duplicate workload.
30-day cooling-off after No Change
If a review results in No Change, that specific sub-criterion cannot be re-opened for 30 days. This protects review capacity and ensures resubmissions arrive with substantially new evidence.
Audit trail
Every request, response, and rationale is preserved. This creates a documented record of how a company's score has evolved over time.
Integrity principles
Not pay-to-play
A company's subscription tier (Listed, Verified, Partner) has no effect on its HOCS score. A Verified company that lacks evidence scores low; a Listed company with strong evidence scores high.
Evidence over opinion
Every score is backed by a justification citing the specific evidence behind it. Confidence indicators (low, medium, high) signal how directly verifiable that evidence is.
No anonymous reviews
HOCS scoring is conducted by Inkwell using a published rubric. The complementary Inkwell Partner Score (community endorsements from verified health system leaders) is structured to surface positive signal only, never anonymous criticism.
Questions about the methodology?
We welcome scrutiny of our scoring approach. If you are a health system leader evaluating a vendor, a startup wanting to understand your score, or an investor calibrating expectations, we are happy to walk through the rubric in detail.
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